Orthopedics Medical Billing Services
Clinic and ASC workflows for fractures, arthroscopy, joint replacement, injections and DME — documented cleanly, coded precisely, reimbursed faster.
98%+ Clean Claims
Eligibility + edits at source
30–45% Faster AR
Prioritized worklists & SLAs
24–48h Posting
ERA/EOB reconciliation
HIPAA + BAA
Secure workflows & audits
Billing & Coding Built for Orthopedics
We convert op notes, imaging, implant logs and therapy documentation into accurate CPT/ICD-10 with correct global period handling.
- Arthroscopy, fracture care (closed/open), injections & grafts
- Bundling/NCCI edits, implant add-ons, laterality & staged care
- Charge capture tied to schedules, OR logs and device records
End-to-End Orthopedics RCM
Clinic, hospital and ASC — from eligibility to appeals and analytics.
Eligibility & Authorizations
Plan checks, auth capture for imaging, surgery & implants.
Coding & Charge Entry
Arthroscopy, fractures, injections, joint replacement, DME.
Claims & Edits
NCCI/MUE, global periods, staged & return-to-OR modifiers.
Payments & AR
24–48h posting, underpayment hunt, prioritized AR follow-up.
Denials & Appeals
Root cause, corrective coding, templated appeals by payer.
Analytics & Compliance
Dashboards, KPIs, audit trails, HIPAA controls & BAAs.
Procedures We Bill Every Day
- Arthroscopy (knee, shoulder, hip) with debridement/repair
- Fracture care: closed treatment, ORIF, external fixation
- Joint replacement & revision; implant add-ons & device logs
- Injections/aspirations (large/small joints), biologics & grafts
- Spine procedures (when applicable) and pain injections
- DME supplies & braces — HCPCS routing and documentation
Payer Nuances We Handle
- Global period tracking for 10/90-day procedures
- Staged & return-to-OR logic with −58/−78/−79
- Laterality & bilateral rules (−RT/−LT, −50) per payer
- Implant add-ons, device logs and medical necessity
- TC/PC splits for imaging and place-of-service impacts
Denial Prevention & Appeals
- Front-end edits for NCCI/MUE conflicts and bundling
- Automated eligibility & auth checks with proof on file
- Appeal playbooks by payer with timely filing tracking
- Underpayment analysis vs contracts & fee schedules
- Feedback loops to providers for documentation gaps
Orthopedics RCM — FAQs
Do you support both clinic and ASC/hospital billing?
Yes — professional claims for clinic visits and procedures, plus ASC/hospital coordination including implant/device records and global periods.
How do you keep ortho denials low?
Up-front edits (NCCI/MUE), global period logic, correct modifiers (−58/−78/−79/−59/−X/−RT/−LT/−50) and quick appeal templates.
How quickly are payments posted?
Within 24–48 hours with ERA/EOB reconciliation, variance checks and prioritized AR worklists.